This Life-Changing Preventative Solution for Osteoporosis Sits on the Sidelines

Image created by Rudy Chidiac. © Open Medical 2024. All Rights Reserved

The lack of Fracture Liaison Services (FLS) is a telling example of how healthcare remains anchored in a reactive ‘diagnose and treat’ approach rather than shifting to a proactive ‘predict and prevent’ model.

FLS was created to identify patients over 50 who have suffered fragility fractures—breaks from low-impact falls related to osteoporosis—and to reduce their risk of even more severe fractures down the line.

Once a person experiences one fragility fracture, there is a 33% chance they will suffer another fracture within 12 months. If the underlying osteoporosis goes untreated, each fracture becomes more devastating, with serious consequences for patients’ lives.

They lose independence. They lose their ability to move freely. Everyday activities like walking, bending, or even standing become painful challenges. Many live in constant pain.

For these patients, FLS is a truly impactful programme. It helps prevent these life-altering, debilitating events. But not only is it impactful for patients, it’s a boon for healthcare systems because treating fragility fractures is resource-intensive and costly. In England, hip fractures alone occupy 1 million acute hospital bed days annually and cost the NHS £2 billion each year.

And yet, only half of NHS trusts have an FLS in place. This leaves around 90,000 people unable to access the care they need and at greater risk of repeat fractures simply because of where they live.

An effective FLS programme can reduce the risk of a second fracture by up to 40% for those enrolled. That’s significant. It’s life-changing.

If FLS were widely implemented, it’s estimated that over five years, it could prevent 74,000 fractures, including 31,000 hip fractures, freeing up 750,000 bed days and saving the NHS £665 million. In fact, for every £1 spent on FLS, the NHS saves £3.26.

Unfortunately, even where there is a FLS in place, it is often under-resourced, run by small teams—sometimes just one person—and lacks effective systems to help with patient management.

Currently, a lot of hospitals with an FLS identify patients manually. They rely on sticky notes, emails, theatre and inpatient lists, word of mouth, phone calls.

Once patients are identified—a feat on its own—they must then be followed up at 4 and 12 months to ensure they are sticking to their treatment plan. Add to that the need to track 11 key performance indicators and enter each one manually into the FLS database. All of this falls to a small, already stretched-thin FLS team to manage.

So patients slip through the cracks and become caught in a cycle of fracture and recovery that strains them and strains an already overwhelmed healthcare system.

It’s not all bad news. There are tools available to streamline workflows and support FLS teams—tools that can make a significant difference.

One hospital in Ireland implemented Pathpoint FLS, a digital solution to automate patient identification and optimise FLS workflow. Before Pathpoint, they identified 71 patients in a year. After Pathpoint, they identified 1,076 patients. That’s a 1,415% increase! The solution automated identification and follow-ups and optimised processes, improving overall patient management.

And yet, despite strong evidence of its impact, FLS is still undervalued. It’s a prime example of how effective preventive care can be but remains largely overlooked.

Expanding FLS and supporting it with technology that streamlines processes would mark a major step towards proactive care—a shift that healthcare urgently needs. It would quite literally change lives for the better, saving valuable resources and costs the NHS sorely needs. Yet, too much funding remains tied up in acute care rather than prevention.

The evidence is clear, the technology is ready, but adoption still lags, and that must change.